Back to library
RARC Code Reference

RARC N36: Claim must meet primary payer's processing requirements before we can consider payment.

Claim must meet primary payer's processing requirements before we can consider payment.

Code type RARC (Remark)
Category Coordination of Benefits

Common CARC pairings

RARCs like N36 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC N36 is most often paired with.

CARCMeaning
22 This care may be covered by another payer per coordination of benefits.
109 Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.
P21 Payment denied based on the Medical Payments Coverage (MPC) and/or Personal Injury Protection (PIP) Benefits jurisdictional regulations, or payment policies. Usage: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Insurance Policy Number Segment (Loop 2100 Other Claim Related Information REF qualifier 'IG') if the jurisdictional regulation applies. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply. To be used for Property and Casualty Auto only.

See the full resolution workflow for RARC N36

Members of the EDI-Code Intelligence Lab get the step-by-step rework path, appeal language, root-cause drivers, and prevention checklist for every RARC and CARC pairing, plus payer-specific quirks.

Open in EDI Lab